CMS surveys nursing homes across dozens of regulatory requirements organized under F-tags, ranging from resident rights to staffing ratios to infection control documentation. A nursing home that doesn't have a systematic compliance checklist doesn't find out about gaps during a self-audit — it finds out from a surveyor.

This guide gives you the compliance framework organized by domain, with the specific checklist items that matter most during a CMS survey. The free download below covers the top-priority checks across all six domains. Department-specific bundles give you the actual printable forms to document your compliance every day.

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Free Nursing Home Compliance Checklist

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✅ Nursing Department ✅ Dietary & Food Safety ✅ Infection Control ✅ Required Postings ✅ Documentation Red Flags ✅ Instant Download

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F725 / F726 — Staffing & Competency Records

CMS F725 Requires You to Track Every Staff Certification — Do You Know Who’s Expiring?

The checklist above shows what surveyors check. The Staff Training Tracker keeps every staff member’s certifications, completion dates, and expiration alerts in one dashboard — so you can prove compliance before surveyors ask. 14-day free trial, no credit card required.

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1

The 6 Domains of Nursing Home Compliance

CMS evaluates nursing home compliance across dozens of F-tags, but they cluster into six core domains. A gap in any domain can result in a deficiency — and deficiencies in high-severity domains (IJ, G, or above) trigger penalties that now appear publicly on Nursing Home Care Compare.

Every compliance program should have a working checklist for each of these six areas:

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Nursing & Clinical Care

Care plans, medication management, fall prevention, wound care, incident documentation. The highest-scrutiny domain in any standard survey.

F655F657F684F689F755F758
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Dietary & Nutrition

Food safety temperatures, special diet accuracy, kitchen sanitation, tray line quality, and Dietary Manager oversight documentation.

F791F800F812F813
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Infection Prevention & Control

IPCP program, hand hygiene compliance, PPE use, isolation protocols, antibiotic stewardship, and monthly surveillance reporting.

F880F881F882F885F886
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Staffing & Workforce

CMS minimum staffing ratios, PBJ reporting accuracy, staff competency records, call-out logs, and license currency verification.

F725F726F727F731
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QAPI Program

Active performance improvement projects, root cause analyses, QAPI committee meeting minutes, and measurable outcome tracking.

F865F866F867F868
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Administration & Documentation

Required postings, grievance logs, resident rights documentation, advance directives, and abuse prevention policy compliance.

F550F572F609F610
⚠ Why Compliance Gaps Cluster

Most survey citations don't come from single isolated failures. They come from systemic documentation gaps — a care plan problem that links to a medication administration problem that links to an incident report problem. The F-tag mapping above shows which tags are interconnected. Fixing F655 (care plans) often surfaces F689 (fall prevention) and F758 (psychotropic meds) gaps on the same resident. A compliance program that audits in silos misses the connections.


2

Nursing Department Compliance Checklist 💉

Nursing is where most surveys are decided. CMS surveyors spend the majority of their time in nursing, reviewing care plans, observing medication passes, checking fall and wound documentation, and interviewing residents about their care. The checklist below covers the items most likely to result in a citation when they're missing or inadequate.

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Nursing Compliance — Core Checklist
Care plans • Medication administration • Falls • Wound care • Incidents
F655Care plans completed within 7 days of admission; each has current problem list, measurable goals, and resident-specific interventions (not template language)
F657Care plans updated within 48–72 hours of any significant change in condition; MDS findings reflected in care plan interventions
F656Resident and/or family participation in care planning documented at least quarterly; refusals to participate are also documented
F755Medication Administration Records (MARs) current and complete; no unexplained blanks; PRN medications have effectiveness documentation within 1 hour
F758Psychotropic medications have documented clinical indication, gradual dose reduction attempts, and behavior monitoring records
F689Fall risk assessments completed on admission, quarterly, and after every fall; post-fall assessments within 24 hours with root cause and intervention updates
F686Wound care assessments weekly for any pressure injury; wound measurements, staging, and treatment documented consistently
F609Incidents reported to state agency within required timeframe; all incidents have an incident report with root cause and corrective action sections completed
F600Abuse and neglect investigation completed within required timeframe; staff training on abuse prevention documented annually
F641MDS assessments completed within CMS required timeframes; coding is accurate and matches clinical documentation in the chart

3

Dietary Department Compliance Checklist 🍴

Dietary is consistently in the top 10 deficiency areas nationally. Surveyors conduct a tray line observation during every standard survey, review temperature logs for the past 90 days, and look for documented staff training on food safety. The three most common dietary citations are food temperature violations, special diet errors, and missing sanitation logs.

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Dietary Compliance — Core Checklist
Food safety • Temperature logs • Special diets • Sanitation • Tray line accuracy
F812Temperature logs current for all food storage (walk-in cooler, freezer) and service points (hot holding); corrective actions documented when out of range
F791Special diet orders in resident chart match tray tickets at meal service; texture modifications and thickened liquid levels verified at tray line
F800Meal delivery times meet regulatory requirements; hot food arrives hot (above 135°F), cold food below 41°F
F812Dishwasher sanitizing temperature or chemical concentration logged at each meal cycle with passing readings
F812Daily, weekly, and monthly kitchen cleaning schedules completed and signed; pest control records current (vendor visit dates, findings, corrective actions)
F812Staff illness exclusion policy posted and enforced; log of exclusions maintained when staff are sent home for GI symptoms, vomiting, or jaundice
F813Registered Dietitian (or qualified designee) completing nutritional assessments and documentation per required timeframes

4

Infection Control Compliance Checklist 🦠

F880 (Infection Prevention and Control Program) is the most frequently cited F-tag nationally, appearing in approximately 74% of SNF surveys with deficiencies. Most citations come from three gaps: no written surveillance data, missing staff training records, and observed PPE practices that contradict the facility's written policy. For the complete department-by-department infection control checklist, see our infection control checklist for nursing homes.

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Infection Control Compliance — Core Checklist
IPCP policy • Surveillance • Staff training • PPE • Antibiotic stewardship
F880Written Infection Prevention and Control Program (IPCP) policy reviewed and updated annually; signed by Infection Preventionist and Administrator
F882Designated Infection Preventionist with at least part-time responsibility; qualifications documented on file
F880Monthly infection surveillance log tracking HAI rates: UTIs, wound infections, respiratory infections, and GI illness with trending data
F880Hand hygiene and PPE training records for all nursing, dietary, housekeeping, and laundry staff — initial hire and annual review documented per employee
F881Antibiotic stewardship program in place; antibiotic use log with culture results, sensitivity data, prescribing rationale, and treatment duration for each course
F885Isolation room signage consistent with CDC guidelines; PPE available outside rooms; staff observed demonstrating correct donning/doffing
F883Resident immunization records current: flu (seasonal), pneumococcal, COVID-19; declination forms on file where applicable

5

Staffing Compliance Checklist 📅

CMS issued minimum staffing requirements in 2024 requiring 3.48 hours of total nurse staffing per resident day, with 0.55 hours of RN staffing and 2.45 hours of CNA staffing daily. Facilities below these thresholds face citation risk. Beyond minimum ratios, surveyors check PBJ data accuracy, staff competency records, and call-out pattern documentation.

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Staffing Compliance — Core Checklist
Minimum staffing • PBJ reporting • Competencies • License verification • Scheduling
F731Current census-based staffing meets CMS minimums: 3.48 hrs total nurse staffing per resident day, 0.55 hrs RN, 2.45 hrs CNA
F731PBJ (Payroll-Based Journal) data submitted quarterly; reported hours match payroll records and scheduling documentation
F725All nursing licenses current and verified; CNAs on state registry; expirations tracked with 60-day renewal notices
F726Annual competency assessments completed and documented for all nursing staff; skills gaps from prior surveys are specifically addressed
F727RN on duty or on call 24/7; documentation of on-call coverage and actual response times when RN called in
F725Call-out log maintained with pattern tracking; employees with recurring call-out patterns have documented corrective action

6

QAPI Compliance Checklist 📊

CMS requires every nursing home to have a written, ongoing QAPI program — not a binder that gets updated before survey. Surveyors ask to see active Performance Improvement Projects (PIPs), recent QAPI committee minutes, and evidence that the facility is using data to drive improvement. Most QAPI programs fail inspection because they exist on paper but not in practice.

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QAPI Compliance — Core Checklist
Active PIPs • Committee meetings • Data tracking • Root cause analysis
F865Written QAPI plan that describes the program's design, scope, governance, and annual review process; signed by Administrator
F866At least two active Performance Improvement Projects (PIPs) addressing current quality concerns; each has a defined aim, baseline data, and measurable target
F867QAPI committee meeting minutes for the past 12 months; attendance documented; data reviewed at each meeting
F868Systematic analysis process for adverse events: any fall with injury, elopement, abuse incident, or medication error triggers a documented root cause analysis
F865Performance data tracked across at least 3 quality indicators (falls, HAIs, pressure injuries, hospitalizations, weight loss, or antipsychotic use) with trend graphs
F867Previous survey deficiencies have active corrective action plans with measurable outcomes documented in QAPI; surveyors check whether prior citations were actually fixed

7

Get the Full Compliance Kits for Your Team

The free checklist above gives you the framework. The FacilityKit department bundles give you the actual printable forms, logs, tracking sheets, and audit tools your team uses every day to document compliance. Every document is CMS-aligned, designed for immediate use, and formatted for binders and daily workflows.

🏆 Most Popular: Survey Survival Bundle

For facilities approaching their annual survey window, the Survey Survival Bundle ($99) covers both sides of the survey: the pre-survey self-audit (mock survey kit) and the post-survey corrective action workflow (plan of correction templates). If you're 90 days or less from your anticipated survey date, this is the highest-value starting point.